Otolaryngology

Pediatric sialorrhea (drooling)

Erin Blanchette — Tue, 14 May 2024 16:36:41 +0000

Date Added:

May 14, 2024

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Canadian Medical Association

Publication Date:

May 12, 2024

Issue:

Volume:

196

Pages:

E624

URL:

Pediatric sialorrhea (drooling)

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.231550

Keywords

PMID (1):

38740417

MeSH

child

Sialorrhea / etiology

Sialorrhea

A concise review of the causes and management of drooling in young children. James W. Mold, MD, MPH

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Sialorrhea is common in children with neurologic impairment

Sialorrhea can be normal in children with typical development until age 4 years. It occurs in as many as 44% of children with cerebral palsy.1 It typically results from poor oral motor control and fluctuates alongside the child’s developmental trajectory. Reversible contributors such as nasal obstruction, dental issues, and medication effects (e.g., benzodiazepines and clozapine) should be considered.

Author/s:

Karan Gandhi, Julie E Strychowsky, Breanna A Chen

Thyroid Cancer: A Review

Erin Blanchette — Mon, 19 Feb 2024 16:44:44 +0000

Date Added:

February 19, 2024

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

February 6, 2024

Issue:

Volume:

331

Pages:

425-435

URL:

Thyroid Cancer: A Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2023.26348

Keywords

Targeted and Immune Therapy

PMID (1):

38319329

MeSH

Thyroid Epithelial Cells

An update on thyroid cancer detection, types, and treatment. James W. Mold, MD, MPH

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Importance: Approximately 43 720 new cases of thyroid carcinoma are expected to be diagnosed in 2023 in the US. Five-year relative survival is approximately 98.5%. This review summarizes current evidence regarding pathophysiology, diagnosis, and management of early-stage and advanced thyroid cancer.

Observations: Papillary thyroid cancer accounts for approximately 84% of all thyroid cancers. Papillary, follicular (≈4%), and oncocytic (≈2%) forms arise from thyroid follicular cells and are termed well-differentiated thyroid cancer. Aggressive forms of follicular cell-derived thyroid cancer are poorly differentiated thyroid cancer (≈5%) and anaplastic thyroid cancer (≈1%). Medullary thyroid cancer (≈4%) arises from parafollicular C cells. Most cases of well-differentiated thyroid cancer are asymptomatic and detected during physical examination or incidentally found on diagnostic imaging studies. For microcarcinomas (≤1 cm), observation without surgical resection can be considered. For tumors larger than 1 cm with or without lymph node metastases, surgery with or without radioactive iodine is curative in most cases. Surgical resection is the preferred approach for patients with recurrent locoregional disease. For metastatic disease, surgical resection or stereotactic body irradiation is favored over systemic therapy (eg, lenvatinib, dabrafenib). Antiangiogenic multikinase inhibitors (eg, sorafenib, lenvatinib, cabozantinib) are approved for thyroid cancer that does not respond to radioactive iodine, with response rates 12% to 65%. Targeted therapies such as dabrafenib and selpercatinib are directed to genetic mutations (BRAF, RET, NTRK, MEK) that give rise to thyroid cancer and are used in patients with advanced thyroid carcinoma.

Conclusions: Approximately 44 000 new cases of thyroid cancer are diagnosed each year in the US, with a 5-year relative survival of 98.5%. Surgery is curative in most cases of well-differentiated thyroid cancer. Radioactive iodine treatment after surgery improves overall survival in patients at high risk of recurrence. Antiangiogenic multikinase inhibitors and targeted therapies to genetic mutations that give rise to thyroid cancer are increasingly used in the treatment of metastatic disease.

Author/s:

Laura Boucai, Mark Zafereo, Maria E Cabanillas

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Devin Evans — Fri, 26 Feb 2021 06:00:00 +0000

Date Added:

February 26, 2021

Journal/Publication:

Journal of the American Board of Family Medicine

Publication Date:

January 31, 2021

Issue:

Volume:

Pages:

216-223

URL:

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2021.01.200199

Keywords

Audiology

clinical decision-making

Conductive Hearing Loss

PMID (1):

33452100

MeSH

physicians, family

Hearing Loss, Sudden

Hearing Loss, Sensorineural

Otolaryngology

Medicine

primary health care

A summary for primary care clinicians of the recently updated ENT guidelines for evaluation and management of sudden acute hearing loss. James W. Mold, MD, MPH

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The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present. We provide this focused review to clarify and disseminate SSNHL guidelines for the frontline family physician.

Author/s:

Prince, Andrew D.P., Stucken, Emily Z.